Abstract: TH-PO1174
Kinetic Estimated Glomerular Filtration Rate (KeGFR), a New Tool to Predict Delayed Graft Function (DGF)?
Session Information
- Transplantation: Clinical - Pretransplant Management
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1901 Transplantation: Basic
Authors
- Garcia Rivera, Alejandro, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Garcia-Vera, Ana Lya, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Sanchez Vazquez, Omar Humberto, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Cisneros-Carbajal, Marlene Del rocio, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Murga, Antonio Mariano, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Jimenez Mejia, Carlos Daniel, Instituto Mexicano Del Seguro Social, Guadalajara, Mexico
- Fonseca cerda, Carlos Francisco, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Muñoz, Teresa, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Velador Mendoza, Jhonatan, Instituto Mexicano del Seguro Social, Zapopan, Mexico
- Parra Michel, Renato, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Hospital General Regional No.46, Instituto Mexicano del Seguro Social., Zapopan, jalisco, Mexico
Background
Delayed graft function (DGF) is a common clinical problem in pediatric patients and in deceased donor kidney transplantation. Early prediction of DGF could be beneficial. It could improve the adjustment of nephrotoxic drugs, such as CNI and antibiotics are routinely used as prophylaxis.
Methods
A retrospective study was carried out, from une 2016 to August 2018, which included 145 kidney transplant patients, either living or deceased kidney donor transplantation, in the immediate postoperative period, in a hospital in Western Mexico. Creatinine was measured at the time of reperfusion (hour 0), and 10 and 18 hours after kidney reperfusion. The Kinetic estimated Glomerular Filtration Rate (KeGFR) was calculated were sCr10h constituted both the basal creatinine and creatinine at first point, and sCr18h was used as creatinine at second point. The primaryoutcome was DGF, defined as need for dialysis (according to the nephrologist consideration) during the first time of transplantation.
Results
157 patients, between 17 and 69 years old, received a kidney transplant during that period, 113 males (71.9%) and 44 females (28.02%); in most of the patients (146/92.9%) the etiology of CKD was unknown. 108 patients (68.7%) received a kidney from a related living donor, 32 patients (20.3%) from a non-related living donor, and 17 (10.8%) patients from a deceased donor. 20 patients presented DGF (12.7%), with a mean GFR estimated with creatinine kinetics (KeGFR) of 5.09 ml/min, while137 patients (87.2%) didn't present DGF and had a mean KeGFR of 14.9 ml/min, with a statistically significant difference and a p value of 0.000. When establishing a KeGFR threshold value of 7 ml/min, it had a sensibility of 70% and a specificity of 81% to predict DGF, with an area under the curve of 0.759.
Conclusion
An eGFR was determined using unstable creatinine values. Our goal was to evaluate the KeGFR using serum creatinine values at 10 and 18 hours after reperfusion of the kidney, which is the time the blood samples are routinely taken in our center. When establishing a KeGFR threshold value of 7 ml/min, we could predict DGF with a sensibility of 70%, a specificity of 81%, and an AUC of 0.759.